Interstitial Kidney Disease

Interstitial nephritis is term to describe a situation where there is inflammation of the space between cells and tubules (the interstitium) within the kidney. This is different to glomerulonephritis, where there is inflammation around the glomerulus. There are two types of interstitial nephritis: acute interstitial nephritis and chronic tubulointerstitial nephritis.

Acute Interstitial Nephritis

Acute interstitial nephritis presents with acute kidney injury and hypertension. There is acute inflammation of the tubules and interstitium. This is usually caused by a hypersensitivity reaction to:

  • Drugs (e.g. NSAIDS or antibiotics)
  • Infection

 

Other features of a generalised hypersensitivity reaction can accompany the acute kidney injury:

  • Rash
  • Fever
  • Eosinophilia

 

Management involves treating the underlying cause. Steroids have a role in reducing inflammation and improving recovery.

 

Chronic Tubulointerstitial Nephritis

Chronic tubulointerstitial nephritis involves chronic inflammation of the tubules and interstitium. It presents with chronic kidney disease.

It has a large number of underlying autoimmune, infectious, iatrogenic and granulomatous disease causes.

Management involves treating the underlying cause. Steroids have a role when guided by a specialist.

 

Last updated April 2019
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